Ear Barotrauma in Children

Ear Barotrauma in Children

Ear barotrauma is inflammation of the middle ear. This condition occurs when an auditory tube (eustachian tube) is blocked in one or both ears. The eustachian tubes lead from the middle ear to the back of the nose (nasopharynx).

This condition typically occurs when a person experiences changes in air pressure, such as when flying or scuba diving. Untreated ear barotrauma may lead to ear damage or hearing loss, which can become permanent.

What are the causes?

The pressure difference that causes ear barotrauma can result from various things, including:

• Flying in an airplane.
• Descending or coming to the surface too quickly when scuba diving.
• Going to higher altitudes quickly.
• Being too close to an explosion or a blast.

What increases the risk?

The following factors may make your child more likely to develop this condition:

• A middle ear infection, a sinus infection, or a cold.
• Environmental allergies.
• Small eustachian tubes.
• Recent ear surgery.

What are the signs or symptoms?

Symptoms of this condition include:

• Ear pain or discomfort. This may cause crying.
• Hearing loss.
• Your child telling you that his or her ear feels clogged.
• Dizziness that feels like a spinning, rocking, or tumbling sensation (vertigo).
• Loss of balance.
• Nausea.
• Ringing in the ears.
• Bleeding from the ears.
• Headache.
• Facial pain.

How is this diagnosed?

This condition may be diagnosed based on:

• A physical exam. Your child’s health care provider may:
  • Use a device (otoscope) to look into your child’s ear canal and check the eardrum.
  • Do a test that changes the air pressure in the middle ear (tympanogram). This test checks how well the eardrum and eustachian tube are working.
• Your child’s medical history and symptoms.
• A hearing test (audiogram).

Your child may be referred to a health care provider who specializes in treating ear conditions (otolaryngologist, or “ENT”).

How is this treated?

This condition may be treated with:

• Medicines to relieve stuffiness (congestion) in the nose, sinus, or upper respiratory tract (decongestants).
• Techniques to “pop” the ears (equalize pressure), such as:
  • Yawning.
  • Chewing gum.
  • Swallowing.
• Surgery to relieve symptoms or prevent future inflammation, in severe cases.

Follow these instructions at home:

• Have your child take over-the-counter and prescription medicines only as told by your child’s health care provider.
• Do not put anything into your child’s ears to clean or unplug them. Ear drops will not help.
• Until your child’s health care provider approves, your child should not:
  • Travel to high altitudes.
  • Fly in an airplane.
  • Scuba dive.
• Keep all follow-up visits as told by your child’s health care provider. This is important.

How is this prevented?

• Using these strategies may help to prevent ear barotrauma:
  • Avoid exposing your child to pressure changes when he or she has symptoms of a cold or congestion.
  • If your child has congestion and will be flying, have your child use a nasal decongestant about 30–60 minutes before flying.
  • When flying, have your child chew gum and swallow frequently and forcefully during takeoff and landing.
  • Have your child hold his or her nose and gently blow to “pop” his or her ears. This forces air into the eustachian tubes and equalizes pressure.
  • Have your child yawn during air pressure changes.
  • If scuba diving, have your child dive feet first and equalize pressure often as he or she goes deeper in the water.

Contact a health care provider if:

• Your child’s symptoms get worse or they do not get better.
• Your child has vertigo.
• Your child has hearing loss.
• Your child has a fever.

Get help right away if:

• Your child has:
  • Severe ear pain.
  • A severe headache.
  • Severe dizziness.
  • Bloody or pus-like drainage from the ears.
  • Balance problems.
• Your child cannot move or feel part of his or her face.

Summary

• Ear barotrauma is inflammation of the middle ear.
• This condition typically occurs when a person experiences changes in pressure, such as when flying or scuba diving.
• Your child may be at a higher risk for this condition if he or she has small eustachian tubes, has had recent ear surgery, or has allergies, a cold, or a sinus or middle ear infection.
• This condition may be treated with medicines or techniques to “pop” your child’s ears (equalize pressure).
• Strategies can be used to help prevent ear barotrauma.